National Provider Identifier [NPI]: |
1265595615 |
Last Name Of The Provider |
WUNDERLICH |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
14540 CORTEZ BLVD |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
BROOKSVILLE |
Zip Code Of The Provider |
346136056 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
2244 |
Number Of Medicare Beneficiaries |
449 |
Total Submitted Charge Amount |
201636 |
Total Medicare Allowed Amount |
167738.38 |
Total Medicare Payment Amount |
121617.68 |
Total Medicare Standardized Payment Amount |
123618.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
136 |
Number Of Medicare Beneficiaries With Drug Services |
121 |
Total Drug Submitted ChargeAmount |
2604 |
Total Drug Medicare AllowedAmount |
2310.95 |
Total Drug Medicare PaymentAmount |
2228.67 |
Total Drug Medicare Standardized Payment Amount |
2228.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
2108 |
Number Of Medicare Beneficiaries With Medical Services |
449 |
Total Medical Submitted Charge Amount |
199032 |
Total Medical Medicare Allowed Amount |
165427.43 |
Total Medical Medicare Payment Amount |
119389.01 |
Total Medical Medicare Standardized Payment Amount |
121389.72 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
185 |
Number Of Beneficiaries Age 75 to 84 |
166 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
317 |
Number Of Male Beneficiaries |
132 |
Number Of Non Hispanic White Beneficiaries |
429 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1355 |